Hyperparathyroidism
Condition
(Overactive Parathyroid)
Definition
Hyperparathyroidism is when the body makes too much parathyroid hormone (PTH). PTH is made in the parathyroid gland. It helps balance calcium levels in the blood. High PTH causes too much calcium in the blood. There are three types:
- Primary
- Secondary
- Tertiary
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Causes
The primary type of hyperparathyroidism may be caused by:
- A noncancerous tumor—this is the most common cause
- Some health problems passed from parents to children
- Cancer—this is rare
The secondary type may be caused by:
- Low levels of vitamin D
- Kidney failure or other health problems
The tertiary type is caused by an enlarged parathyroid. It can happen with long term kidney failure.
Risk Factors
This condition is more common in older adults, especially women. Other things that may raise the risk of hyperparathyroidism are:
- Having family members with this health problem
- Radiation to the head or neck
- Kidney failure or rickets
Symptoms
Most people do not have symptoms of hyperparathyroidism. Those who do may have:
- Joint or back pain
- Digestive problems such as:
- Heartburn
- Belly pain
- Constipation
- Nausea and vomiting
- Loss of interest in eating
- Headache
- Thirst
- Urinating often
- Kidney stones
- Anxiety, depression, or confusion
- Tiredness or weakness
Diagnosis
The doctor will ask about symptoms and past health. A physical exam will be done.
Hyperparathyroidism is diagnosed with blood and urine tests. The doctor may also do a scan of the parathyroid gland. Other scans may be done such to check the kidneys and bones.
Treatment
The goal of treatment is to help the body make the right amount of PTH. How this is done depends on the cause. Options may be:
- Surgery to remove tumors
- Medicine to treat symptoms and keep levels of calcium and vitamin D in the normal range
- Management of kidney disease, if present
Blood calcium levels may need to be checked on a regular basis. It can help find problems early. Other tests can also help look for related problems such as bone density tests.
Prevention
Hyperparathyroidism cannot always be prevented. Getting enough calcium and vitamin D may help prevent secondary hyperparathyroidism.
Healthy amounts of calcium and vitamin D may prevent primary hyperparathyroidism in women.
Endocrine Society
The American Association of Endocrine Surgeons
CANADIAN RESOURCES:
Health Canada
The Canadian Society of Endocrinology and Metabolism
Endocrine Society
The American Association of Endocrine Surgeons
CANADIAN RESOURCES:
Health Canada
The Canadian Society of Endocrinology and Metabolism
References
- Hyperparathyroidism. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/hyperparathyroidism.
- Primary hyperparathyroidism. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/primary-hyperparathyroidism.
- Secondary hyperparathyroidism. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/secondary-hyperparathyroidism.
- Tertiary hyperparathyroidism. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/tertiary-hyperparathyroidism.
- Walker, M., and Bilezikian, P. Primary hyperparathyroidism: recent advances. Curr Opin Rheumatol, 2018; 30 (4): 427-439.
Contributors
- Marcin Chwistek, MD
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